Please note: The information listed below only applies to Hospital Services and is subject to change. The HSS Insurance Advisory Service can provide you with the most up-to-date information at 212.774.2607. For more information regarding specific physician practices, please contact the individual physician offices or the Physician Referral Service at 877.606.1555.

Hospital for Special Surgery is NOT an in-network provider for Empire's Medicare Managed/Advantage and Medicaid Managed Care plans.

New York City Employee Health Insurance PlanHospital for Special Surgery is an in-network provider for New York City employees who have health insurance under New York City's Comprehensive Benefits Plan provided by Empire Blue Cross Blue Shield PPO. Please note: Empire Blue Cross Blue Shield covers your inpatient and outpatient surgical services under this plan. All other services, such as outpatient diagnostic services (x-ray, laboratory, etc.) and physician services are provided under your GHI plan. Hospital for Special Surgery is NOT an in-network provider with GHI.

New York State Employee Health Insurance Plan (NYSHIP or the Empire Plan)Hospital for Special Surgery is an in-network provider for New York State employees covered by the “Empire Plan.” Please note: Empire Blue Cross Blue Shield covers only your inpatient and outpatient hospital services under this plan. United Healthcare provides the network of physicians. Not all United Healthcare in-network physicians participate with the Empire Plan.

Some, but not all, out-of-area Blue Cross Blue Shield plans include Hospital for Special Surgery as an in-network provider through the National PPO BlueCard® Program. The BlueCard® program allows you to access in-network benefits from other local Blue Cross PPO plans and all authorized and covered services provided by the hospital would be subject to your in-network deductibles and coinsurance levels. The existence of the “PPO in a suitcase logo” on your member identification card typically confirms your plan’s participation in the BlueCard® program.

UniCare Affiliated PPOMembers of the UniCare Affiliated PPO plans have in-network access to Hospital for Special Surgery through an affiliation with Empire Blue Cross Blue Shield.

Hospital for Special Surgery is participating with Traditional New York State Medicaid insurance. You are responsible for any co-payments. If you are enrolled in a Medicaid Managed Care HMO, Child Health Plus and Family Health Plus plan your benefits and coverage at Hospital for Special Surgery may be limited. Please contact VOICES Medicaid Managed Care Education Program at 212.774.2011 to determine your options at Hospital for Special Surgery.

Hospital for Special Surgery is participating with Traditional Medicare insurance. You are responsible for co-insurance and deductible costs. If you are enrolled in a Medicare Managed Care/Advantage plan, the benefits and coverage at Hospital for Special Surgery may be limited. For further information please call the HSS Insurance Advisory Service at 212.774.2607 or email your question through our online form.

Hospital for Special Surgery is a participating provider with Multiplan/PHCS. In-network status depends upon your policy's plan. Please call your plan’s customer service phone number to determine if the services of the Hospital will be considered in-network.

Hospital for Special Surgery accepts Workers' Compensation. You must have a valid case/claim number and authorization (if applicable) prior to seeking care at HSS.

If you have specific questions regarding the plans with which the Hospital participates, please call the HSS Insurance Advisory Service at 212.774.2607 or email your question through our online form. The HSS Insurance Advisory Service can serve as a liaison service among you, your insurance carrier, and the Hospital to provide information regarding your insurance coverage. You may be responsible for payment of deductibles and co-insurance amounts, and you may be subject to other limitations, such as pre-certification requirements.

If the Hospital does not participate with your particular insurance plan, you still may have coverage subject to the availability of "out-of-network" benefits. The HSS Insurance Advisory Service can advise you.

Your surgeon, your anesthesiologist, your medical doctors, and other specialists make their own decisions regarding participation in insurance plans. There are many physicians affiliated with the Hospital who participate in the same insurance plans with which the Hospital itself participates. For more information regarding specific physician practices, please contact the individual physician offices or the Physician Referral Service at 877.606.1555.

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Important Phone Numbers

Insurance Advisory Service212.774.2607

Financial Assistance Program212.606.1505

VOICES Medicaid Managed Care Education Program212.774.2011

Physician Referral Service877.606.1555

Your Healthcare, Your Choice

Making informed decisions about your healthcare can make all the difference in the quality of care and outcomes you receive.